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Home My WebLink AboutPermit Building 1996-03-20OREGON SPRINGFIELD RESIDENTIAI. PERMIT APPI.ICATION CITY OF SPRINGFIELD CO}IMT'NITY SERVICES DIVISION BUII.DING SAFETY Page 1 Job Nnmber: 9602LL 225 North Fifth street Springfield, OR 97477 tocatsion of Proposed $lork: 300 N 22![D ST Assessors Map #: 17033613 Lot: Block: Office: Inspection Line: 726 -37 59 725 -37 69 Tax Lot #: 02900 Subdivision: OwneT: CIIARI,ES GRIFFIN Address: 300 NORTH 22ND STREET Phone #: 484-2L55 city/state/zrp: SPRINGFTELD, OREGON 97477 DeSCribE WOTK: GAR,AGE CON1IERSION REMODEI, General: Plumbing: Mechanical: Electrical: ContracEor OWNER OI^INER OWNER OWNER Const. ContracEor #Expires Phone 484-21,65 QUAD AREA: 2RNW -- OFFICE USE -- LAND USE: 1111 To request an inspection, caLL the 24 hour recording aL 726'3759. A11 inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the foLlowing work day. --- REQUTRED TNSPECTTONS --- POST AIID BEAITI - Prior to floor insulation or decking. INSULATION - Fl-oor; prior to decking wa1l/Ceiling; Prior to cover ROUGH PLITIIBING - Prior to cover. ROUGH ELECTRICAL - Prior to cover. FRAIIING - Prior to cover. INSULATION - Floor; prior Eo decking wa}]/Ceiling; Prior to cover DRYWALL - Prior to Laping. FINAL PLITMBING - When all plumbing work is comp1etse. FINAL ELECTRICAL - When all electrical work is compleLe. FINAL BUILDING - When at1 reguired inspections have been approved and the building is complete. Item Main Garage GARAGE CONVERSION Total- Value Building Permit Fee Surcharge/admin --- BUILDING PERMIT --- Square Feet x $/Sguare Feet Value 0.00 0.00 9, 180 . 00 9, l_80 . 00 80.50 6 .45 TOTAI, FEE 2L3 43.1 (A)85. 95 CITY OF siPHINGFIELD Job Nnmber: 95O2LL CITY OF SPilNGFIELD, ONEGON Page 2 --- PLI'IfBING PERITIT --- Item Fixtures Plumbing Permit surcharge/edmin TOTAL CI{ARGE 1 Fee 10.00 15.00 L.20 L6.20(c) -.- MISCELIJANEOUS PERMITS --- Surcharge/admin ELECTRICAL PERMIT PLAN REVIEW FEE TOTAI. }II SCEI,I.AIiIEOUS PER}TITS (E) 0.00 44.28 52.33 95.51 (Excluding EJ,ectrical ) unlegg otherwige noted --- TOTAL AITOI'NT DUE --- (A, B, C, D, and E corrbined)L99 .7 6 --- BUILDING VALITE, PLAIiI CHECK A]ID BUILDING PERIIIT --- This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violati-on of any provisions of said ordinances. Received By: P1ans Reviewed By: DON MOORE Building Site Reviewed By: LISA HOPPER Date: 03/L9/96 --- ADDITIONAI, COU}IEI(ITS --- MIMIMUM COMPONENT PATH, SEPARATE ELECTRICAL PERMIT IS REQUIRED By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I furLher certify Ehat any and all work performed shafl be done in accordance with Ehe Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wil-I be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with oRs 701-.055 will be used on this project. I further agree to ensure that all reguired inspections are reguested at the proper time, that each address is readabLe from the street, that the permit card is locaLed at the fronL of the property, and the approved set of plans will remain on the site at all times during construcEion. 3'zo:14 Signature Date SPRIITIGFTELD .Tob Number: 96021-1- CITY OF ONEGON Page 3 --- VALTDATION --- Receipt Number QA7 % Date Paid , 7 -2a ,% Amount Received, / 9?.7e Received By .4:r**-?" SPR.--rFlELl) ul)a Services or Feeders InstalIation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPS - 401 amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amPs/volts - Reconnect OnlY SUBTOTAL OF ABOVE 52 State Surcharge 3Z Administrative Fee TOTAL efr, I ! : :lliTllx s:Hr, Rff,?y$*,r.T! aprproval 225 FTYTE STREET SPRINGFIELD, OREGON 97 INSPECTION REQUEST: 7 OFFICE: 726-3759 JA (,ELECTRICAL PERHIT APPLICATION ob Ntrmber471) 1. LOCATI ON OF ON LEGAL DESCRIPTION JOB DESCRIPTION Permit, ".. non-transferable and expire ii ,ort is not started vithin 180 days "i iitr."ce or if vork is suspended for 180 days. , , 2. CONTRACTOR INSTAII.A'TION ONLY Electrical Con tractor 2!*4v4 Address Ci ty Phone Supervisor License Number Exp iration Date Cons t r Contr. Number Expiration Date Signature of Supervising Electrician COHPLETE FEE SCffiDTIl,E BELOV Nev Res j,dential-Single or MuIti-FamilY Per dvelling unit' Service rncluded t , a"rn. cos t 1-000 sq.ft. or less S 85'00 Each additional 500 t.sq. ft or Portionthereof s 1'5'oo Each Manuf'd Home' or Modular Dvelling Service or Feeder S 40'00 3 A B C E s s0.00 s 60.00 sr.0o.0o s130.00 s300.00 s 40.00 Sum a6ove TemporarY Services or Feeders insiallaiiot, Alteration or Relocation 200 amps''or less 201 amps to 400 amPS - Over 401 to 600 amPs Over 600 amps or 1000-voTTs s 40.00 $ ss.00 $ 80.00 see ttBtt Ci tY Phone #/-?b0 D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit z/- g 35.00 35_a Each Addi tional Circuit or vith Service or Feeder Permi t 3 S 2'00 -b? The installation is being made on property I ovn vhj-ch is not intended for sale, lease or rent' Miscellaneous ( Service/feeder -Each installati.on Pump or irrigation $ Limited Energy/Res S Limi ted Energy/Comm S OVNER INSTAIT-ATION Signa ture: not 40. included ) 00 00 00 fr 40. 20. 36. 5 DATE:2. zRECETPT RECEIVED i ,( ovners N^^. Clfu,b a'4/md eddr""" ,fro N , 22& 3T, D SrJfi)7/- Permit #: - 2=*6 Darc:>?E_'?6Issued by ?, Address: Statemeht: lnformation Notice to Property Owners About Construction Responsibi lities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a buitding permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38: 1. I own, reside in, or will reside in the completed structure' 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3.A.. My general contractor is (Name)Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. f 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above informationis correctand thatl have read and dounderstand thelnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 3.to-q / (Signature of wfrffi^"r) (White copy to issuing agency permit file, pink copy to applicant) OR V (Date) lrxfornrtiition-Notice to Propeffiy Swmer* . ...,- -. - : _ AMut **r"1.stru*t&*tt ffiewp*nx*hi$$tB*m.]- \ ; - -.Norc: ll:t:, !nJr'rtnctt,rs;t Notire.ta Property {.}wrz*:rs't;.hat:$ {-avt:;iru.fii.r;vt flq;'.1;r;i,1'1'li"j;yyg5.:ta'- "v,as dt:t't!op*l hy the toiist'iuctip$ Coyrtractors Er;rsrcl i,r; t;t-i:o?"{!rsit.t i-, ,t,ii!, {..1;?.5 7{}1.055(5). \ you can prev,eilt marey. probleris by bei"ng ;rware.cf the fr:llowing responsirbihties nnd ai'ea:; *f cofirerl" : .,'),,, - ; EMPLOYEB fiE-SpONSIBILITIES: If you hire persons n*t registered rvith the Construction Contractors Board to do Iahc;r in ilclnsit-tictirug or assis{ing in ttre cr:nstruction or improv*inent of a residential stflrcture, you will, in mosi insta*e es, be rLlled to be an ernptroyer anrl the pei:ple you hire will be emplol'ees. As rhe employer, you must comply rvith thc following: Oregon's withholding tax law: As,ar{ ernployer, you must withhold inccnle taxes from emplo}ee wages at the time empioyees are paid" Yr:u will be liable fbr the tax payrlents even if yrru don't'actually withhold the tax from your employ'ees. For more information, call the Oregon Dept. of Revenue at 945.8091 Unemployment inslrrance tax: As an ernployer, yor.r ;re required to pay a tax for unemployment insurance purposes on the wages of all emptoyees. For mr:r* infgrn'r*1ion, call the,Qregoq.Employmenr Division at the pep+,61r-nent of,;Hurnan seqqrrygp at318-3524. Workers' compensatiom ixlsurance: As an ernployer, yorj ere subject to the Cregon Workeisi Clmpensation Law, and m*l obtain workers' compensatii:n insurance for yaur emgloyees if you fail to obtain workers' colnpexsation insurance, )iourrnail bb subject to penaitie.s and willbe tiitte for irlt'clairn'Jtisis if one nf you, "nrployees is injurect on the.lob.if'oi mcire inforr.i{tio-n-i ca.!l the Workers' Con"lpensation Division at the l)epartmert of Consumer ani'i tsusihei.s Serviceis-Ct g4S-?898. - - US,Internal Revenue Service: As an employer, you rnr:st withhold federal income tax &ern ernployeed'wa$ei. Voo *ltiUd liai:le forthe tex paymen{ e ve* if yau did*'r actnally r.vithhold the taa. Fcr r*$r* inf*rmation. ca}X the Int*mai R^eve;:u* fiervice at l-800-829-1040. STHEffi RESPCINSIBILXTIM$ ANS AMM&S QF ESNCHRN: Cade cclmpliance : As th* pennit holcler for this project, ysu ar* responsihl': for resoXving any failur* t* meet c*de r*quircn:r:nts that rnay be brought {o yi}ur attention through inspectians. ':' Liabili{r and property damage insurance: Contact your in$urimce agt:nt to s*e if yr:u hav* adeguate insurance coverag* lbr aee idents and omissions such as falling tools, paint overspray, water darnage liom pipe punctures, fire, or work that must he re-done. Tirne {* s*p*rvise er*gli*yces; hdake riure ycu have sufficlent {iiivt.' lrr sup.:t 1 is.t \,,;tr ernpl*-vees. *xprrtis*: Make sure you have the expedise t* act as your own general contr;rctcr. to cr:orclinate the wcrk of r*ugh-irl and finistl trarJes, aud to notify l:uilding officials at the appr*priate times so they can perforrn the required inspectiotrs, trf yr11 have a*litionai qubsilns, write *r cali the Construction Co:ril:actprs'tspard,(PQ.Eox t414O,jSq{em-OR 9?3{l-q-505?, 513fi1e-4621). The Bnarri is located at ?0{} Sumrner St" NE Suite 300, in $alem. prop-own.pm4 1t94